Endoscopic ablation with cyanoacrylate glue for isolated gastric variceal bleeding

Modified devascularization surgery for isolated gastric varices assessed by endoscopic ultrasonography

“…These techniques have enabled the classification of IGV into types 1 (fundic) and 2 (cardiac) according to the origins and numbers of feeding vessels and the distribution of gastric varices from portographic features. However, our findings are not consistent with a recent study describing type 1 vascular anatomy as much more common in the localized-type gastric varices [11]. In contrast, type 2 vascular anatomy was found almost exclusively in the diffuse-type gastric varices according to endoscopic observation.…”

Color Doppler findings of gastric varices compared with findings on computed tomography

“…Using Doppler sonography, Ishii et al 19 reported that the main feeders of fundic gastric varices were collaterals near the splenic hilum in 82% of the patients, and mean blood flow velocity in the feeding veins was greater in bleeders than in nonbleeders. Iwase et al 20 reported the differences in hemodynamic features between localized-type gastric varices and diffuse-type varices. According to their article, patients with localized-type varices had a better clinical course, with regard to rates of recurrent bleeding, variceal eradication, and survival, than those with diffuse-type varices, after endoscopic ablation with cyanoacrylate.…”

Update on Treatment of Variceal Hemorrhage

“…In patients with hepatocellular carcinoma complicated by variceal bleeding, a single injection of cyanoacrylate has been shown to be as effective as weekly injection of sodium tetradecyl sulfate [52]. Cyanoacrylate also offers the best results in the treatment of gastric varices [53]. While it is a potent hemostatic agent, dreadful complications such as thromboembolism of the pulmonary, coronary, and cerebral vessels have been reported.…”